NEXTGENIMMUNIZATIONSDEMONSTRATION

This demonstration reviews some of the Immunization workflow in NextGen. Details of will likely vary somewhat depending on practice policy & clinic layout, though this should give you a good idea of NextGen functionality.

This has been prepared with EHR 5.8 & KBM 8.3. Subsequent updates may display cosmetic & functional changes.

Use the keyboard or mouse to pause, review, & resume as necessary.

Introduction

There is a lot of variation in immunization workflow. Sometimes orders may be initiated by providers; sometimes they may be initiated by nursing staff in response to a provider’s request or office standing order. Either way, they are usually completed by the nurses.

Introduction

Some offices heavily use the Alabama ImmPRINT sustem, while others less so. Currently NextGen is not interfacing with ImmPRINT, though we hope we will at least be able to transmit the vaccines we administer in NextGen to ImmPRINT in the coming months.

The EHR will keep you informed of changes as they occur.

Immunizations can be reached from several different locations in NextGen. Many working templates will have links to immunizations at the top.

The Navigation Bar will also provide access to immunizations.

Other places will have immunizations links as well, such as this spot on the Intake Tab.

The Order Module is yet another way to begin immunization workflow.

You can also access vaccinations by clicking the Immunizations bullet at the top of the Order Management template.

For the purposes of this demonstration, we’ll start with a 3 year old who has some vaccines documented in ImmPRINT, but has had nothing documented in NextGen. And there are a few things due today. Click Peds Immunizations at the top.

The Immunization - Pediatric template opens. Notice that the adult version of the template is also available in the other tab. This is handy, since you often have to move back & forth between the two.

Since no vaccinations have been entered in NextGen, everything shows as due.

Notice there are 2 tabs; here we’re on Chart.

There are a number of resources available. Click Web Links for some of these. Notice that catch-up & travel vaccination schedules are available.

Others are available through the Web button.

On the Recommendation tab you can review the current vaccination schedule.

Back on the Chart tab, our patient has had her 2, 4, 6, & 12 month DTaP vaccines done, so let’s look at options to record that. Click Exclusions.

You’ll see a list of vaccines on the left, but often the names are cut off. However, if you hover the mouse over them, it will display the full name.

You’ll find most vaccines you need on this list, but if necessary the Search Vaccines button would give you a way to find any others.

With a vaccine selected, on the Exclusions tab you can select reasons this vaccine will be deferred, adding an expiration date for the exclusion & comments as necessary.

One workflow would be to enter an “exclusion” since the child is up to date until her 4th birthday.

However, this doesn’t include the details of the earlier vaccines, so this isn’t really the most thorough way to go about it. But if you plan to print vaccination records from ImmPRINT, this would not be an unreasonable approach.(We’ll look at another alternative in a minute.)

On the Series Completion tab, you could enter info about vaccine series that are now done, with no further immunizations needed.

Click Save to record this. You could make further entries as necessary.

We probably won’t use the Other Exclusions tab for the foreseeable future, so just close the popup.

Note the status of the Hepatitis A series has been updated.

Now click Historical.

Vaccines that are incomplete are in red. Series that are either complete or not due yet are in blue.

Now click DTap.

When done click Save All.

Enter details about the first DTaP vaccine.

(When the ImmPRINT interface is working, you could click Save & Send to enter it & transmit to ImmPRINT at the same time.)

The date of the first DTaP now displays.

If you again click Historical & repeat this process 3 more times for the second – fourth vaccines…

…you’ll see all the dates, with the status changed to Current.

Obviously, this is pretty tedious, so clinics will need to decide whether they want to go through this process—especially if the information is readily available through ImmPRINT.

Note that, while you don’t have a quick way to enter all doses of a single series at one time, you can enter multiple different vaccines, which can come in handy when several were given on the same day.

For the sake of demonstration, other vaccinations have been entered.

Now let’s work on the vaccines that are still due. Click New Order.

This opens the Order Module, focused on the Immtab.

You could’ve also gotten here by clicking the Order Module Icon on the tic-tac-toe board.

As before, vaccines that are due are in red, & those that are either complete or not due yet are in blue.

Select VFC Reason if appropriate.

Now click Allergies.(If you didn’t do this now, it would give you another chance later on when you pick a vaccine to order.)

Recorded allergies display.

When done click Save.

Let’s click No To All Allergies to simultaneously answer all 4 questions.

Check MMR & Varicella, moving them to the Ordered section at the bottom.

If this is the provider, the next step might be to click Save or Save & Task to give the order to the nurse.

If this is the nurse, you might next go to the Vaccine Details tab, which leads to this popup.

Here you can document providing the Vaccine Information Statement. Enter the Date then click Document As Given if you’ve given the mom a paper copy, or Print/Print All to print out a copy.

Here the nurse can document administration details. If your clinic’s stock has been entered in the vaccine inventory, you can pick many of these details from picklists. Otherwise, information may need to be entered manually.

Select each vaccine & enter details.

When details for each have been entered, click Save.

All immunizations now show as current.

If NextGen holds a complete list of the patient’s vaccinations, you can print out a shot record by clicking Immunization Record.

The Immunization – Adult template is very similar, just with fewer vaccines listed.

There will also be more times when you need to order something not on the schedule, for example, for patients with indications for Pneumovax & Prevnar before age 65, or who are traveling abroad.

This concludes theNextGen Immunization

demonstration.

There are only 10 kinds of people in the world—

those who understand binary, and those who don’t.

R. Lamar Duffy, M.D.Associate ProfessorUniversity of South AlabamaCollege of MedicineDepartment of Family Medicine

This concludes theNextGen Immunization

demonstration.

xxxxxxxxx.

R. Lamar Duffy, M.D.Associate ProfessorUniversity of South AlabamaCollege of MedicineDepartment of Family Medicine

There are only 10 kinds of people in the world—

those who understand binary, and those who don’t.